• Parveen Usman Aga Khan University
  • Habib Qaisar Aga Khan University
  • Anwar ul haque Liaquat National Hospital
  • Qalab Abbas Assistant Professor, PICU, AKUH, Karachi


Background: To compare the Paediatric RIFLE (p-RIFLE) and Kidney Disease Improving Global Outcomes (KDIGO) definitions of acute kidney injury (AKI) for frequency of (AKI) and in-hospital mortality in critically ill children. Methods: Retrospective review of medical records of all patients (aged 1 month – 16 years) admitted in Paediatric Intensive Care Unit from January 2015–December 2016, with length of stay >48 hours, was done. Patients with chronic kidney disease were excluded. Receiver operating characteristic (ROC) curves were used to evaluate the performance of the p-RIFLE and KDIGO criteria to predict the AKI related mortality. Logistic regression analysis was done to determine the association of different variables with mortality in AKI patient based on p-RIFLE, KDIGO. A p-value of <0.05 was considered significant. Results: Out of total 823 patients admitted during the study period, 562 patients were included in the study. Median age was 2 years (Interquartile range 8 years). AKI frequency according to p-RIFLE and KDIGO were 391 (70%), and 372 (66%) respectively. Overall, 106/823 (12.8%) children died during study period, 78 (19.9%) in AKI by p-RIFLE and 76 (20.4%) in AKI by KDIGO died. The area-under- curve for in-hospital mortality for p-RIFLE and KDIGO criteria were 0.525 (p=0.427), and 0.534 (p=0.276), respectively. Conclusion: P-RIFLE is more sensitive compared to KDIGO in diagnosing AKI in critically ill children; identifying a greater number of moderate staged AKI cases. Greater AKI severity is associated with higher mortality in critically ill children.

Author Biographies

Parveen Usman, Aga Khan University

Senior Medical Offcier

Habib Qaisar, Aga Khan University

Senior Medical Officer

Anwar ul haque, Liaquat National Hospital



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